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    v1.0.28
    OpenPayerBilling CodesHematology and Coagulation ProceduresCPT cpt-85240-factor-viii-antihemophilic-globulin-serum-assay
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    CPT 85240: Factor VIII Antihemophilic Globulin (Clotting) Test

    CPT code 85240 describes a laboratory clotting assay performed by a lab analyst to detect factor VIII antihemophilic globulin (an antibody against factor VIII) in patient serum; the service is a specialized coagulation immunoassay typically performed in a clinical laboratory or hospital laboratory setting as part of evaluation for hemophilia A inhibitors or unexplained bleeding.

    For related coverage guidance, see recent payer policy updates: Epithelial Cell Cytology in Breast Cancer Risk Assessment, Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only), Antibody-Drug Conjugates.

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    Clinical & Coding Specifications

    Clinical Context

    A 28-year-old male with a history of easy bruising and prolonged bleeding after a dental extraction is referred to hematology for evaluation of suspected hemophilia A or acquired factor VIII inhibitors. A phlebotomist draws blood and the specimen is sent to the laboratory. The clinical laboratory technician performs a clotting assay specifically to detect the presence of factor VIII antihemophilic globulin (factor VIII inhibitor) in the patient’s serum. The workflow includes specimen receipt and accessioning, separation of serum, performance of the clotting test (Bethesda or equivalent inhibitor assay technique), calculation of inhibitor titer, verification by a laboratory director, and reporting of results to the ordering hematologist.

    • Service type: Diagnostic coagulation laboratory test for factor VIII inhibitor detection.

    • Typical site of service: Hospital laboratory, independent clinical laboratory, or outpatient reference laboratory supporting hematology clinics.

    • Typical patient scenario: Patients with unexplained bleeding, prolonged activated partial thromboplastin time (aPTT) not corrected by mixing studies, recurrent hemarthroses, or patients with known hemophilia A who develop a sudden loss of factor VIII efficacy after factor replacement therapy.

    • Result use: Confirms presence and estimates titer of factor VIII inhibitors to guide treatment decisions such as immune tolerance induction, bypassing agents, or modification of replacement therapy.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    85302Prothrombin time; plasma or whole blood, quantitativeOften performed alongside factor assays to evaluate overall coagulation status and differential diagnoses.
    85320Activated partial thromboplastin time (aPTT)Common initial screening test for intrinsic pathway defects; abnormal aPTT may prompt factor VIII inhibitor testing.
    85241The lab analyst performs a clotting test to determine the presence of factor IX antihemophilic globulin in the patient’s serum.Performed in parallel when hemophilia B or factor IX inhibitors are suspected; related inhibitor testing workflow.
    86140Antibody; quantitative, micro-organism, or toxin (e.g., hepatitis) — Note: example antibody assay codeOther serologic or antibody assays may be ordered concurrently depending on clinical context (e.g., viral serologies before immune tolerance).
    85384Mixing study, plasma or whole bloodPerformed before specific inhibitor assays to determine whether a prolonged clotting time corrects with normal plasma or suggests an inhibitor.

    Related Modifiers

    5 rows

    ModifierDescriptionWhen to Use
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    59Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
    90Modifier ‑90 (Reference/Outside Laboratory) indicates that a laboratory test was performed by an entity other than the treating or reporting provider. The American Medical Association defines…- Use CPT modifier -90 when a laboratory test is performed by an outside/reference laboratory (an entity other than the treating or reporting physician or qualified professional) and the claim needs…
    91Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…
    95Modifier 95 indicates that a service was provided via synchronous, real‑time audio‑video telehealth rather than in‑person. Per CMS, AAPC and professional associations, append modifier 95 to claim…- Use modifier 95 to indicate a service was furnished via synchronous, real‑time audiovisual telehealth (a live audio‑video conference between patient and provider) rather than in‑person. - Pair…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    207K00000XAllergy & Immunology PhysicianAn allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    207LP2900XPain Medicine (Anesthesiology) PhysicianAn anesthesiologist who provides a high level of care, either as a primary physician or consultant, for patients experiencing problems with acute, chr…
    385HR2060XChild Intellectual and/or Developmental Disabilities Respite CareA facility or distinct part of a facility that provides short term, residential care to children diagnosed with intellectual and/or developmental disa…
    282E00000XLong Term Care HospitalLong-term care hospitals (LTCHs) furnish extended medical and rehabilitative care to individuals who are clinically complex and have multiple acute or…
    261QR1300XRural Health Clinic/CenterAmbulatory Health Care Facilities · Clinic/Center
    225500000XRespiratory/Developmental/Rehabilitative Specialist/TechnologistGeneral classification identifying individuals who are trained on a specific piece of equipment or technical procedure.

    Related ICD-10-CM Codes

    19 rows

    ICD-10-CM CodeDescription
    C83.99Non-follicular (diffuse) lymphoma, unspecified, extranodal and solid organ sites
    C91.00Acute lymphoblastic leukemia not having achieved remission
    C95.90Leukemia, unspecified not having achieved remission
    D66Hereditary factor VIII deficiency
    D67Hereditary factor IX deficiency
    D68.1Hereditary factor XI deficiency
    D68.2Hereditary deficiency of other clotting factors
    D68.4Acquired coagulation factor deficiency
    D69.3Immune thrombocytopenic purpura
    D69.6Thrombocytopenia, unspecified

    Showing 1–10 of 19

    Related Payer Policy Updates

    Specialty: Hematology/Oncology1 / 3

    4 rows

    PolicyPayerEffective Date
    Epithelial Cell Cytology in Breast Cancer Risk AssessmentOscar Health2026-10-01
    Chemotherapy Observation or Inpatient Hospitalization (for New Mexico Only)UnitedHealthcare2026-08-01
    Antibody-Drug ConjugatesPremera Bluecross2026-08-01
    Umbilical Cord Blood Harvesting and Storage for Future Use (for Indiana Only)UnitedHealthcare2026-08-01

    Related Codes

    CPT-85002-BLEEDING-TIME-TEST-LABORATORY

    CPT 85002: Bleeding Time Test, Technical Component

    CPT-85004-AUTOMATED-DIFFERENTIAL-WHITE-BLOOD-CELL-COUNT

    CPT 85004: Automated White Blood Cell Differential

    CPT-85007-MANUAL-DIFFERENTIAL-WHITE-BLOOD-CELL-COUNT

    CPT 85007: Manual Differential White Blood Cell Count

    CPT-85008-BLOOD-SMEAR-MORPHOLOGIC-REVIEW-NO-DIFFERENTIAL

    CPT 85008: Microscopic Blood Smear Examination, No Differential

    CPT-85009-MANUAL-WBC-COUNT-BUFFY-COAT

    CPT 85009: Manual White Blood Cell Count Using Buffy Coat

    CPT-85013-MICROHEMATOCRIT-TEST-LABORATORY-DIAGNOSTIC

    CPT 85013: Microhematocrit Test by Tube Centrifugation

    CPT-85014-HEMATOCRIT-VOLUME-PERCENT-RED-BLOOD-CELLS

    CPT 85014: Hematocrit (Volume Percent of Red Blood Cells)

    CPT-85018-HEMOGLOBIN-ASSAY-WHOLE-BLOOD

    CPT 85018: Hemoglobin Measurement in Whole Blood

    CPT-85025-COMPLETE-BLOOD-COUNT-CBC

    CPT 85025: Complete Blood Count (CBC)

    CPT-85027-COMPLETE-BLOOD-COUNT-HGB-HCT

    CPT 85027: Complete Blood Count with Hemoglobin and Hematocrit

    Showing 1–10 of 99

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    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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